An instrument in the following form satisfies the requirements of subdivisions 55-10A-9(1)(a) and (7):

TRANSFER UNDER THE SOUTH DAKOTA UNIFORM TRANSFERS TO

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MINORS ACT

I, ______________ (name of transferor or name and representative capacity if a fiduciary) hereby transfer to ______________ (name of custodian), as custodian for ______________ (name of minor) under the South Dakota Uniform Transfers to Minors Act, the following: (insert a description of the custodial property sufficient to identify it).

Dated: __________________

________________________

(Signature)

______________ (name of custodian) acknowledges receipt of the property described above as custodian for the minor named above under the (Name of Enacting State) Uniform Transfers to Minors Act.

Dated: __________________

________________________

(Signature of Custodian)

Source: SL 1986, ch 409, § 10.